Felecia Rosser
Ascend Home Health Care (part-time)
Balch Springs
12
years of professional experience
Dedicated healthcare professional with more than 20 years of experience in customer service, healthcare, pharmacy, claims, and individual member services. Extensive knowledge of Medicare, commercial health plans, pharmacy benefits, claims processing, benefit verification, prior authorizations, appeals, and member education.
Recognized for delivering exceptional customer service in high-volume call center environments while assisting members, providers, and internal departments. Skilled in resolving complex issues, educating members on health plan benefits, maintaining HIPAA compliance, and improving customer satisfaction through effective communication and problem-solving.
Work History
Caregiver Attendant
9 Years 7 Months- Provided compassionate support for daily living activities, enhancing clients' quality of life.
- Assisted with personal care tasks, including bathing, grooming, and meal preparation.
- Monitored client health conditions and reported changes to nursing staff promptly.
- Collaborated with healthcare teams to develop personalized care plans for clients.
- Conducted regular assessments of patient needs, adjusting care plans as necessary for improved quality of life.
Provider Services Representative
4 Months- Assisted commercial members and providers through inbound calls, written correspondence, and online inquiries
- Educated members and providers on benefits, claims, authorizations, expedited appeals, and coverage details in
- Coordinated with internal departments on behalf of providers to ensure timely payment resolution for claims disputes or other financial matters.
- Enhanced customer satisfaction by efficiently resolving provider inquiries and concerns.
- Led initiatives to optimize data management within CRM systems, Zendesk ,VBA increasing accuracy of provider information records.
- Resolved complex member issues while ensuring first-call resolution whenever possible
Senior Member Services Representative
9 Years 1 Month- Assisted Medicare members through inbound calls, written correspondence, and online inquiries
- Educated members on benefits, claims, authorizations, expedited appeals, and coverage details
- Resolved complex member issues while ensuring first-call resolution whenever possible
- Supported prescription processing, prior authorizations, and pharmacy overrides
- Maintained accurate documentation and data entry in compliance with HIPAA regulations
- Utilized systems including GPS, PeopleSafe, MedCompass, Compass, and Salesforce CRM
- Handled escalated calls with professionalism, empathy, and strong conflict resolution skills
- Cross-trained in claims, pharmacy, and eTech support functions
- Collaborated with internal departments to improve efficiency and member satisfaction
- Trained and mentored new Member Services employees on policies and procedures
- Generated reports using Microsoft Office and maintained productivity and quality metrics
Customer Service Associate III
2 Years 4 Months- Resolved customer inquiries through effective communication and active listening techniques.
- Managed order processing, ensuring timely fulfillment and accuracy in transactions.
- Collaborated with team members to enhance customer service workflows and efficiency.
- Trained new associates on product knowledge and company policies to ensure consistent service delivery.
Education
High School Diploma
Skills
Call center experience
Customer service expertise
Client relationship building
Team management
Sales experience
Policy enforcement
Strong leadership
Teamwork
Teamwork and collaboration
Customer service
Problem-solving
Problem-solving skills
Time management
Attention to detail
Problem-solving abilities
Multitasking
Multitasking Abilities
Calm and professional under pressure
Reliability
Excellent communication
Computer skills
Understanding customer needs
Customer service excellence
Organizational skills
Team collaboration
Shipping and receiving
Verbal and written communication
Problem resolution
Teamwork skills
Decision-making
Effective communication
Active listening
Calm under pressure
Adaptability and flexibility
Customer relationship management
Quality control
Issue and complaint resolution
Professionalism
Goal setting
Customer data confidentiality
Project management
Customer retention
Billing procedures
Professional telephone demeanor
Quality assurance
Written communication
Customer relationship management (CRM)
Policies and procedures adherence
Order fulfillment
Data management
Document and records management
Problem-solving aptitude
Emotional intelligence
HIPAA compliance
Claims processing
Goal-oriented mindset
Insurance verification
Provider relations
Compliance management
Timeline
Provider Services Representative
Angle Health Insurance (Temp)Medix
04.2026 - 08.2026Read More
Caregiver Attendant
Ascend Home Health Care (part-time)
01.2017 - CurrentRead More
Senior Member Services Representative
CVS/caremark Aetna
07.2016 - 08.2025Read More
Customer Service Associate III
Arbonne International LLC
03.2014 - 07.2016Read More
Lake Highlands Highschool
High School Diploma
Read More